Article Text
Abstract
Objectives The aim of our study was to evaluate the feasibility of the modified International Germ Cell Cancer Collaborative Group risk classification system in Chinese female patients with malignant ovarian germ cell tumors and to identify predictive factors to enhance the risk classification system.
Methods In this retrospective cohort analysis, patients with malignant ovarian germ cell tumors who received surgery with/without chemotherapy were included. These patients had been followed-up by Peking Union Medical College Hospital between 2011 to 2020. Patients without complete medical records or no follow-up information were excluded.
Results The study enrolled a total of 271 patients. The risk model classified 106 (39.1%) patients as good-, 84 (31%) as intermediate-, and 81 (29.9%) as poor-risk. With a median follow-up time of 34 months (range 2–147), 48 (17.7%) recurrence and 16 (5.9%) deaths were observed. The risk classification significantly correlated with 3 year disease-free survival and overall survival (log rank p<0.001 and p=0.003, respectively). The survival outcomes of disease-free survival and overall survival were not statistically different among risk groups in patients who received neoadjuvant chemotherapy (log rank p=0.77 and 0.41, respectively). Univariate and multivariable analysis showed that tumor stage (p=0.033, hazard ratio (HR) 2.05, 95% confidence interval (CI) 1.06 to 3.96) was significantly associated with relapse or progression of disease. Patients over age 40 years exhibited a poor prognosis.
Conclusion The modified International Germ Cell Cancer Collaborative Group risk classification system was efficacious in patients with malignant ovarian germ cell tumors and was significantly associated with disease-free survival and overall survival. Risk assessment after neoadjuvant chemotherapy may be more predictive than stratification at initial diagnosis. Age and tumor stage were definitive prognostic factors for germ cell tumors, which may need to be incorporated in the stratification system.
- Ovarian Neoplasms
- Ovarian Diseases
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Footnotes
X @Jie59063832
Contributors Conception and design: XZ, JieY, JiaxinY. Provision of study material or patients: JiaxinY, YX, MW, DC, JW. Data collection and interpretation: XZ. Statistical analysis: XZ, JieY. Manuscript preparation: XZ, JieY. Final approval of manuscript: All authors. Accountable for all aspects of the work: All authors. Guarantors: XZ, JieY.
Funding This study was supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS) [2022-I2M-C&T-B-023], National Key R&D Program of China [2022YFC2704400], National High Level Hospital Clinical Research Funding [2022-PUMCH-B-083].
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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